Echo:
Left - Right outflow though open oval section and the vsd with pressure equalizing between two ventricles (PG 22mmHG). High flow through pulmonary arteries and high returns through pulmonary veins

Conclusion:

Medium size muscular vsd near the aortic valve with important Left - Right outflow though open oval section.
Recommended new examination in one month

Doctor concerned about the high pressures and fears of the event to create pulmonary hypertension

As a father I would like to inform you that the child has so far not present any obvious problem.

Typically a 4 mm ventricular septal defect (VSD) does not cause a moderate-sized shunt. In fact, the pressure across that defect should be much higher than 22 mmHg, as it should be restrictive to blood flow across it. Without evaluating your daughter, I cannot say what is happening here. There are times that certain babies have elevated right sided pressures, such as if they live at altitude, have Trisomy-21 (Down syndrome), or if the defect is LARGER than 4 mm, which is may actually be in this case. Ordinarily, we like to treat these patients with anticongestive medications, if they need them, and then surgically close the defect prior to about 9-12 months if it remains nonrestrictive and there is evidence of persistently elevated right sided pressures. You may want to discuss this further with the cardiologist and find out why she has the higher right sided pressure, and what the further plan is.

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